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Comment by pearjuice | Hacker News Reader

Have fun with the biotics which will grow resistant after a while!

I'm unsure what you point is. Our current antibiotics are already producing resistant strains. We can either develop something completely new, or lace existing antibiotics with silver. Unless you are in this field and have some insight to bestow on us, I don't know of any other approaches at the moment. Improving our current methods by bolstering them with silver could be what we need to gain a new advantage against resistant strains.

Is it possible that we will eventually produce strains resistant to even this? Yes. Is the answer to just give up drop all attempts at antibiotics? Probably not.

At least part of the answer is to use antibiotics less, and to do more to ensure that when they are used, the full course is used.

This prevents production of more resistant strains, but we already have resistant strains out there. (Also, @pearjuice seemed to indirectly imply that the ability to improve our existing antibiotics was a bad thing)

>but we already have resistant strains out there.

But those resistant strains will be outcompeted by non-resistant strains without the presence of anti-biotics.

There is a fitness cost to most resistance mechanisms [1]

[1] http://www.ncbi.nlm.nih.gov/pubmed/20208551

> At least part of the answer is to use antibiotics less, and to do more to ensure that when they are used, the full course is used.

If it gets bad enough, outpatient antibiotics use will be a thing of the past. Need antibiotics? You're staying in a facility where someone will monitor you and make sure you take the full course and don't make our resistance problems worse. It won't necessarily be a hospital and you won't necessarily be watched by doctors or nurses, but compliance will be mandatory and enforced.

I hope it doesn't get that bad.

Antibiotics are a recent human invention, so it isn't surprising that resistance to them is still increasing. Silver, on the other hand, has been present in the environment since before bacteria evolved. If there was an accessible pathway to silver resistance, it would have been found in several billion years.

Silver may be common in some places, but IIRC it isn't common inside animals or plants. So if you are a bacteria producing an infection, you would not expect to find a lot of silver inside your target. The metabolically paths that have resistance are usually more expensive, so the cheap path is usually selected and the other unused path is lost after some generations lost dew to random mutations.

It's possible that there exist some strange bacteria that feed on sulfur components and live inside mines with high silver concentration that have special mechanism to handle silver, but I think they are not very happy eating meat.

The genes for penicillin resistance predate the use of penicillin as an antibiotic. Perhaps there are genes which confer silver resistance which will be increasingly expressed as silver is used as a treatment.

That sounds interesting, but have you got a link to that paper/explanation? With the mutations happening all the time it seems to me like the question "can you step twice into the same river?" is close to what applies in this case.

> Antibiotics are a recent human invention

Fungus could tell another history, about how they design, make and use exactly the same compounds since thousands, maybe millions of years for the same purposes.

Resistance is just one possible evolutionary response. Avoidance is another.

If silver is potent enough, that may not be an issue. While it is hypothetically possible for biotics to develop resistance to sterilization via sulfuric acid, to my knowledge none have. If your treatment operates with fundamental chemistry (rather than complicated interactions between large organic molecules) and is powerful enough, the biotics don't get a chance to develop resistance. Or at least, that's how I understand it.

For example, I would consider osmosis to be a "fundamental chemistry" form of action. The only organisms I know of that can tolerate ridiculously high osmotic pressures are extremophiles. They developed resistance, yes, but they had the opportunity to gradually develop on the fringes of these extreme environments, instead of simply being dropped into a pool of salt.

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